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PA CHEST PROJECTION - ERECT
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Describe the direction of the central ray:
Describe the direction of the central ray:
CR perpendicular to the IR.
Where will you center for a PA chest?
Where will you center for a PA chest?
On the MSP at the level of T7 (18-20cm below vertebral prominence, or to the inferior border of the scapula).
How do you evaluate the rotation?
How do you evaluate the rotation?
Rotation can lead to distortion of the shape and size of the heart shadow. Medial aspect of the sterno-clavicular (SC) joints should be equidistant to the spinous processes (tear drops) of T3-T4. Distance from lateral rib margins to the vertebral column at any given rib or vertebra must be equal on each side from upper to lower rib cage. This will ensure equal density of the lungs. Lateral margins of the vertebral body must be equidistant to the spinous process. Compare each rib shape. They should be equal in shape and length. Compare the scapulae for equal and sufficient forward rotation to prevent superimposition of the scapulae over the lung fields. 1/3 of heart on right side and 2/3 on left side of the vertebral column will indicate no rotation of the thorax.
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